Background <p>Psychiatric disorders are commonly treated with medications that can alter salivary gland function and lead to xerostomia. Reduced saliva flow and increased oral dryness can significantly impact oral health and quality of life. The aim of this study was to evaluate both subjective and objective indicators of salivary gland function among psychiatric outpatients in Hungary and to explore the potential xerogenic effects of the most frequently prescribed psychiatric drugs.</p> Method <p>A total of 188 psychiatric outpatients (70 men, 118 women) and 173 age- and sex-matched healthy controls (80 men, 93 women) were examined. Subjective sicca symptoms were assessed using a 16-question xerostomia questionnaire. Objective measurements included the determination of unstimulated whole salivary secretion rate and minor salivary gland secretion rates (palatal and labial), and dental caries experience was evaluated using the DMFT index. Descriptive statistics and multiple linear regression analyses were performed to assess the effects of demographic and medication variables on salivary parameters and DMFT.</p> Results <p>Psychiatric patients exhibited lower unstimulated whole salivary secretion rate (females) and labial minor salivary gland secretion rates, alongside higher xerostomia frequency and DMFT values, compared with controls. The most commonly prescribed drugs were benzodiazepines (80%) and atypical antipsychotics (67%), with frequent concomitant use of multiple psychiatric medications. Regression analyses identified age and psychiatric group as predictors of reduced salivary secretion and increased DMFT scores. Typical antipsychotic use showed a weak positive association with unstimulated whole salivary secretion rate, while benzodiazepine and lithium use correlated with higher palatal minor salivary gland secretion. Age strongly predicted increased DMFT.</p> Conclusions <p>Psychiatric patients demonstrated impaired salivary gland function and poorer dental health compared with healthy individuals. While the associations between specific drug classes and salivary parameters were mostly weak, long-term psychopharmacological treatment and drug combinations appear to contribute to the high prevalence of xerostomia in this population. Awareness of these effects is essential for implementing preventive oral care strategies in psychiatric patients. A potential limitation of the study is that unstimulated saliva collection in control participants was performed during routine dental visits, where situational stress may have transiently influenced flow rates.</p> Trial registration <p>This study was retrospectively registered at ClinicalTrials.gov (NCT06920472; public release: 05/19/2025).</p>